UNDERSTANDING CHILD DEVELOPMENT

“It is easier to build strong children than to repair broken men.” Frederick Douglass (1817-1895)

CHILD BRAIN DEVELOPMENT

The brain is developed through an ongoing process that begins during pregnancy and continues into early adulthood. The foundations of the brain begin to form between birth and five years of age as a child sees, feels, tastes, hears, and smells. Seven hundred new neural connectors are formed every second during a child’s first years. This forms the sturdy foundation that will affect the learning, health, and behaviors that follow.

The process of pruning begins after this initial period of rapid proliferation. During pruning, neural connections are reduced, cause brain circuits to become more efficient. Then, sensory pathways, such as basic vision and hearing, develop. Next, the development of early language skills and higher cognitive functions begins. These connections proliferate and prune in a specific, beginning with basic function and then moving on to more complex brain circuits built upon earlier, simpler circuits.

A close relationship between the child and the caregiver is the best way to nourish the child’s growing brain. Young children learn by interactions with adults—the children babble and make facial expressions and gestures, while the adult responds with similar vocalizations and gestures. In the absence of such responses—or if the responses are unreliable or inappropriate—the brain’s architecture does not form as expected, which can lead to disparities in learning and behavior.

Brain development can also be impaired by chronic or unrelenting stress that occurs in early childhood from events such as poverty, abuse, or sever maternal depression. Positive stressors are important and necessary for typical development; however, toxic stress can caused damaged neurons that will inadequately shape the developing brain.

FURTHER READING

40 Developmental Assets

The Search Institute identified the 40 building blocks necessary for healthy development—known as Developmental Assets—that help young children grow up healthy, caring, and responsible. This particular list is intended for adolescents (age 12-18).

PRESENTATIONS

“Minor is Major: How Adolescent Braind and Behavior Development Can Affect Competency, Culpability and Other Determinations in Criminal Court” by Cathryn S. Crawford, NACDL 2016 Mid-Winter Meeting. Download the presentation.

Abstract: The justice system in the United States has long recognized that juvenile offenders are not the same as adults, and has tried to incorporate those differences into law and policy. But only in recent decades have behavioral scientists and neuroscientists, along with policymakers, looked rigorously at developmental differences, seeking answers to two overarching questions: Are young offenders, purely by virtue of their immaturity, different from older individuals who commit crimes? And, if they are, how should justice policy take this into account?

A growing body of research on adolescent development now confirms that teenagers are indeed inherently different from adults, not only in their behaviors, but also (and of course relatedly) in the ways their brains function. These findings have influenced a series of Supreme Court decisions relating to the treatment of adolescents, and have led legislators and other policymakers across the country to adopt a range of developmentally informed justice policies.

New research is showing distinct changes in the brains of young adults, ages 18 to 21, suggesting that they too may be immature in ways that are relevant to justice policy. This knowledge brief from the MacArthur Foundation Research Network on Law and Neuroscience considers the implications of this new research. Purchase access to the brief.

“Gender Differences in the Developmental Cascade From Harsh Parenting to Educational Attainment: An Evolutionary Perspective” by Rochelle F. Hentges and Ming-Te Wang, Child Development (2017)

Abstract: This study utilized life history theory to test a developmental cascade model linking harsh parenting to low educational attainment. Multigroup models were examined to test for potential gender differences. The sample consisted of 1,482 adolescents followed up for 9 years starting in seventh grade (Mage = 12.74). Results supported indirect links between harsh parenting and low educational attainment through the development of extreme peer orientations, early sexual behavior, and delinquency. Among male adolescents, harsh parenting was related to the development of an extreme peer orientation, which further led to increased delinquency, and subsequently lower educational attainment. Among female adolescents, harsh parenting predicted extreme peer orientations, which increased both delinquency and early sexual behavior. Early sexual behavior further predicted lower educational attainment in female adolescents. Purchase access to the full article.

“Searching for Signatures of Brain Maturity: What Are We Searching For?” by Leah H. Somerville, Neuroview (2016)

Abstract: Evidence of continued neurobiological maturation through adolescence is increasingly invoked in discussions of youth-focused policies. This should motivate neuroscientists to grapple with core issues such as the definition of brain maturation, how to quantify it, and how to precisely translate this knowledge to broader audiences. Purchase access to the article.

“Applying the Science of Child Development in Child Welfare Systems” by Steven D. Cohen, The Center on the Developing Child at Harvard University (2016)

Abstract: How can we use insights from cutting-edge science to improve the well-being and long-term life prospects of the most vulnerable children in our society? This is both a critical challenge and a powerful opportunity to affect the trajectories of millions of children in the United States and around the world. It is a question of particular importance to those who make or affect public policy. This paper shows how the science of child development can be leveraged to strengthen and improve the public child welfare system so that it can better support the children, families, and communities it serves.

The paper is intended for leaders in the public agencies responsible for child protection and related functions; in the private, non-profit agencies that provide many of the services in these systems; in the courts, which play a critical role in child welfare; in legislative committees that oversee child welfare and related services; and in the many other public systems, such as early childhood education, mental health, and juvenile justice, whose support is essential to success in child welfare. Read the full paper.

Abstract: This study leveraged data from the Minnesota Longitudinal Study of Risk and Adaptation (N = 243) to investigate the predictive significance of maternal sensitivity during the first three years of life for social and academic competence through age 32 years. Structural model comparisons replicated previous findings that early maternal sensitivity predicts social skills and academic achievement through mid-adolescence in a manner consistent with an Enduring Effects model of development and extended these findings using heterotypic indicators of social (effectiveness of romantic engagement) and academic competence (educational attainment) during adulthood. Although early socioeconomic factors and child gender accounted for the predictive significance of maternal sensitivity for social competence, covariates did not fully account for associations between early sensitivity and academic outcomes. Read the full article.

Young Children Develop in an Environment of Relationships by the National Scientific Council on the Developing Child (2014)

Abstract: An “environment of relationships” is crucial for the development of a child’s brain architecture, which lays the foundation for later outcomes such as academic performance, mental health, and interpersonal skills. However, many of our nation’s policies fail to consider the importance of adult-child relationships for child well-being. This working paper from the National Scientific Council on the Developing Child explains how these relationships shape child development, and identifies ways to strengthen policies that affect those relationships in the early childhood years. Read the full paper.

The Science of Neglect: The Persistent Absence of Responsive Care Disrupts the Developing Brain by the National Scientific Council on the Developing Child (2012)

Abstract: Young children who experience severe deprivation or neglect can experience a range of negative consequences. Neglect can delay brain development, impair executive function skills, and disrupt the body’s stress response. This working paper from the National Scientific Council on the Developing Child explains why neglect is so harmful in the earliest years of life, and why effective interventions can improve long-term outcomes in learning, health, and the parenting of the next generation. Read the full paper.

Excessive Stress Disrupts the Architecture of the Developing Brain by the National Scientific Council on the Developing Child (2004)

Abstract: This working paper from the National Scientific Council on the Developing Child defines the concept of “toxic stress”—what happens when children experience severe, prolonged adversity without adult support. It discusses how significant adversity early in life can alter a child’s capacity to learn and adapt to stressful situations, as well as how sensitive and responsive caregiving can buffer the effects of such stress. The paper also suggests how to create policies that minimize the disruptive impacts of toxic stress on young children. Read the full paper.

Abstract: Pediatric neuroimaging studies up to now exclusively cross sectional, identify linear decreases in cortical gray matter and increases in white matter across ages 4 to 20. In this large-scale longitudinal pediatric neuroimaging study, we confirmed linear increases in white matter, but demonstrated nonlinear changes in cortical gray matter, with a preadolescent increase followed by a postadolescent decrease. These changes in cortical gray matter were regionally specific, with developmental curves for the frontal and parietal lobe peaking at about age 12 and for the temporal lobe at about age 16, whereas cortical gray matter continued to increase in the occipital lobe through age 20. Download the full article.

“Piecing Together Mother’s Stress and Baby’s Genetics to Understand Brain Development” by Jim Hudziak, The American Journal of Psychiatry (2015)

This article analyzes how the circumstances of pregnancy, especially stress levels for the mother, interacts with offspring genomic architecture to influence brain development. Read the full article.

DOCUMENTARIES

Monkey Love (2005)

This documentary explores the life of Harry Harlow, a psychologist who focused his research on maternal separation, dependency needs, and social isolation. This film clip features his experiments using rhesus monkeys to study the role of caregiving and companionship in social development and cognitive development.

CHILDHOOD TRAUMA

The word trauma is used to describe negative events that are emotionally painful and that overwhelm a person’s ability to cope. Interpersonal or intentional trauma, such as childhood abuse or neglect, tends to have the most severe adverse psychological effects on children. Trauma can also occur when there is sexual abuse or psychological abuse.

Children can suffer trauma at any age as they are maturing and developing. However, early childhood trauma generally refers to the traumatic experiences that occur from birth up to age six. Because infants’ and young children’s reactions may be different from older children’s, and since they may not be able to verbalize their reactions to threatening or dangerous events, many people assume that young age protects children from the impact of traumatic experiences. On the contrary, a growing body of research has established that young children, even infants, may be affected by events that threaten their safety or the safety of their parents and caregivers.

When children are exposed to multiple traumatic events in their lifetime, they are defined as having suffered complex trauma. Complex trauma can have devastating effects on a child’s physiology, emotional development and impulse control, self-image and self-esteem, interpersonal relationships, and the ability to think, learn, and concentrate. Studies have shown that complex trauma can lead to other issues, including substance abuse and addiction, chronic physical conditions, and mental illness.

If a child does not form healthy attachments with caregivers, he or she will be more likely to experience stress, which may cause the child to have trouble controlling and effectively expressing his or her emotions. The child may also be prone to violent or inappropriate reactions. Normal biological functions can be impaired, because when a child grows up afraid or under persistent or high levels of stress, the child’s immune and stress response systems may develop abnormally. Children who have experienced complex trauma often have difficulty with the expression and management of their emotions.

Dissociation—the mental separation from traumatic events—may also be seen in children. This can affect a child’s ability to be fully present in activities of daily life and can significantly fracture a child’s sense of time and continuity, which can have adverse affects on learning and classroom behavior, as well as his social interactions with peers. Trauma may cause a child to struggle with self-regulation—causing a lack in impulse control or the ability to adequately think through consequences before acting. Children who suffered trauma may have problems thinking clearly, reasoning, and solving problems—causing them to be unable to plan ahead, anticipate the future, and act accordingly. Childhood trauma can have long-term consequences on a person. A child cannot be blamed for the trauma they suffered or the harm that it has caused their development.

FURTHER READING

SCIENTIFIC ARTICLES

Abstract: Childhood trauma, including abuse and neglect, is probably the nation’s single most important public health challenge, a challenge that has the potential to be largely resolved by appropriate prevention and intervention. Each year over 3,000,000 children are reported to the authorities for abuse and/or neglect in the United States of which about one million are substantiated. Many thousands more undergo traumatic medical and surgical procedures, and are victims of accidents and of community violence. However, most trauma begins at home: the vast majority of people (about 80 %) responsible for child maltreatment are children’s own parents. Read the full article.

Abstract: Among juvenile offenders, those who commit the greatest number and the most violent offenses are referred to as serious, violent, and chronic (SVC) offenders. However, current practices typically identify SVC offenders only after they have committed their prolific and costly offenses. While several studies have examined risk factors of SVCs, no screening tool has been developed to identify children at risk of SVC offending. This study aims to examine how effective the adverse childhood experiences index, a childhood trauma-based screening tool developed in the medical field, is at identifying children at higher risk of SVC offending. Data on the history of childhood trauma, abuse, neglect, criminal behavior, and other criminological risk factors for offending among 22,575 delinquent youth referred to the Florida Department of Juvenile Justice are analyzed, with results suggesting that each additional adverse experience a child experiences increases the risk of becoming a serious, violent, and chronic juvenile offender by 35, when controlling for other risk factors for criminal behavior. These findings suggest that the ACE score could be used by practitioners as a first-line screening tool to identify children at risk of SVC offending before significant downstream wreckage occurs. Purchase access to the full article.

SPEAKER PRESENTATIONS

Abstract: In this TED Talk, pediatrician Nadine Burke Harris explains that the repeated stress of abuse, neglect, and parents struggling with mental health or substance abuse issues has real, tangible effects on the development of the brain. This unfolds across a lifetime, to the point where those who’ve experienced high levels of trauma are at triple the risk for heart disease and lung cancer. An impassioned plea for pediatric medicine to confront the prevention and treatment of trauma, head-on. Watch the full TED Talk or read the transcript.

JUDGMENT AND DECISION-MAKING

The juvenile brain is still maturing in the teen years and well into the early to mid-20s. Research on the brain shows that juveniles’ brains work differently than adults when they make decisions or solve problems. Their actions are guided more by the emotional and reactive amygdala and less by the thoughtful, logical frontal cortex. Because the brain is not fully developed by the teenage years, this makes juveniles are more vulnerable or susceptible to negative influences and outside pressures, including peer pressure, causing them to have less control over their environment.

This does not mean that a juvenile is incapable of making a rational decision or appreciate the difference between right and wrong. It can mean—particularly when confronted with stressful or emotional decisions—that a juvenile is more likely to act impulsively, on instinct, without fully understanding or analyzing the consequences of his or her actions. When compared to adults, juveniles are generally more impulsive, aggressive, emotionally volatile, risky, and reactive in their behaviors. Their desire for peer approval can shape their behavioral decisions even without direct coercion.

Abstract:
Importance: Attention-deficit/hyperactivity disorder (ADHD) has been associated with deficient decision making and learning. Models of ADHD have suggested that these deficits could be caused by impaired reward prediction errors (RPEs). Reward prediction errors are signals that indicate violations of expectations and are known to be encoded by the dopaminergic system. However, the precise learning and decision-making deficits and their neurobiological correlates in ADHD are not well known.

Objective: To determine the impaired decision-making and learning mechanisms in juvenile ADHD using advanced computational models, as well as the related neural RPE processes using multimodal neuroimaging.

Main Outcomes and Measures: Learning and decision making were investigated by contrasting a hierarchical Bayesian model with an advanced reinforcement learning model and by comparing the model parameters. The neural correlates of RPEs were studied in functional magnetic resonance imaging and electroencephalogram.

“Maturity of Judgment in Adolescence: Psychosocial Factors in Adolescent Decision Making” by Laurence Steinberg and Elizabeth Cauffman, Law and Human Behavior (1996)

Abstract: To date, analyses of differences between adolescents’ and adults’ judgment have emphasized age differences in cognitive factors presumed to affect decision making. In contrast, this article examines research and theory on three psychosocial aspects of maturity of judgment: responsibility, temperance, and perspective. For several psychosocial dimensions of maturity that are likely to affect judgment, the existing evidence, while indirect and imperfect, indicates that the greatest differences are found in comparisons between early adolescents versus middle and late adolescents. Developmental research on maturity that focuses specifically on mid- and late adolescence, that simultaneously examines both cognitive and noncognitive factors, and that investigates the relation. Purchase access to the full article.

Abstract: Considerable controversy focuses on the ages at which adolescents are permitted to make legally regulated decisions—for example, consent to medical treatment, consent to experimentation, choice of custodial parent. The decision advice of 108 adolescents at three grade levels (grades 7-8, 10, and 12) was investigated in a simulated peer-counseling situation. In adolescents’ advice to their “peers,” there is a significant increase, with grade level, in mention of the potential risks and potential future consequences of decisions; in recognition and cautious treatment of “vested interests”; and in advice to solicit independent professional opinions. No differences between grade levels are found in the incorporation of negative information about a trusted adult or in recommendations that peers or parents be consulted about the decisions. Purhcase access to the full article.

LEGAL ARTICLES

“Brain Science and the Theory of Juvenile Mens Rea“ by Jenny E. Carroll, North Carolina Law Review (2016)

Abstract: The law has long recognized the distinction between adults and children. A legally designated age determines who can vote, exercise reproductive rights, voluntarily discontinue their education, buy alcohol or tobacco, marry, drive a car, or obtain a tattoo. The Supreme Court has repeatedly upheld such age-based restrictions, most recently constructing an Eighth Amendment jurisprudence that bars the application of certain penalties to juvenile offenders and a Fourth Amendment jurisprudence that contemplates an adolescent-based standard of reasonableness for the Miranda v. Arizona custody analysis. In the cases of Roper v. Simmons, Graham v. Florida, Miller v. Alabama, and J.D.B. v. North Carolina, the Court’s jurisprudence of youth relies on emerging neuroscience to confirm what the parents of any teenager have long suspected: adolescents’ cognitive abilities and thought processes differ from their adult counterparts. Children are different than adults.

In the cases of Roper, Graham, and Miller, the Court recognized that brain development affects the legal construct of culpability and should accordingly affect punishment. In the Roper case line, the Court reasoned that without mature thought processes and cognitive abilities, adolescents as a class fail to achieve the requisite level of culpability demonstrated in adult offenders. As such, juveniles were categorically spared the death penalty and, in some instances, a sentence of life in prison without the possibility of parole. Likewise, in J.D.B., the Court concluded that the reasonableness of a juvenile defendant’s perception of custody under Miranda v. Arizona must be age appropriate. The Court concluded that as a class adolescents had a different understanding of custodial status than adults. Courts contemplating the validity of a perception of custody under Miranda had to account for this difference in their analysis.

To date, the Court has limited the application of this principle to punishment and consent analysis under Miranda. The logic of the Court’s decisions, however, applies just as strongly to the application of substantive criminal law. Likewise, scholars writing in the field have limited the application of neuroscience to either the territory staked out by the Court or to objective mens rea standards alone. The science, however, does not support such limitations. Just as modern neuroscience counsels against the imposition of certain penalties on juvenile offenders and an adjustment of Miranda’s reasonableness analysis, so it counsels toward a reconsideration of culpability as applied to juvenile offenders through the element of mens rea. The failure to extend this jurisprudence of youth to every mental state element undermines the very role of mens rea as a mechanism to determine guilt. Read the full article.

“Less Guilty by Reason of Adolescence Developmental Immaturity, Diminished Responsibility, and the Juvenile Death Penalty” by Laurence Steinberg and Elizabeth S. Scott, American Psychologist (2003)

Abstract: The authors use a developmental perspective to examine questions about the criminal culpability of juveniles and the juvenile death penalty. Under principles of criminal law, culpability is mitigated when the actor’s decisionmaking capacity is diminished, when the criminal act was coerced, or when the act was out of character. The authors argue that juveniles should not be held to the same standards of criminal responsibility as adults, because adolescents’ decision-making capacity is diminished, they are less able to resist coercive influence, and their character is still undergoing change. The uniqueness of immaturity as a mitigating condition argues for a commitment to a legal environment under which most youths are dealt with in a separate justice system and none are eligible for capital punishment. Read the full article.

Abstract: Two features of the legal regulation of childhood seem troublesome, but ultimately contribute to sensible policies in most contexts. First, the boundary between childhood and adulthood varies in different policy domains, through a regime of age grading under which elementary school students are deemed adults for some legal purposes, while, for other purposes, college students are children. Second, the transitional stage of adolescence is virtually invisible, because, for most purposes, law makers employ binary categories, classifying adolescents as either children or as adults. This framework—a series of legislative bright line rules, arrayed around a presumptive age of majority—generally promotes social welfare as well as the interests of youth. Although this approach sometimes distorts developmental reality, it accomplishes the transition from legal childhood to adulthood over time without incurring the costs associated with the creation of intermediate legal category. Indeed, the unsuccessful experience with abortion regulation (in which adolescents occupy a special category) confirms the benefits of binary classification.

In the context of juvenile justice policy, however, categorical assumptions that ignore the developmental stage of adolescence have harmful outcomes. In responding to youth crime, law makers have shifted the boundary of childhood dramatically during the 20th century. The Progressive architects of the traditional juvenile court described delinquent youths as innocent children, and constructed policies that presumed that the state’s sole purpose was to promote their welfare. Contemporary conservatives, in contrast, assume that young offenders are indistinguishable from adult criminals, and argue that public protection demands that they be subject to the same punishment. I argue that both of these accounts represent distortions and have been the basis of unsatisfactory policies – even in terms of the professed objectives of their adherents. A justice policy that treats adolescence as a distinct legal category not only will promote youth welfare, but will also advance the utilitarian objectives of reducing the costs of youth crime. Read the full article.

Abstract: Challenges the use by policy researchers of a model for comparing adolescent and adult decision making that is based on informed consent standards. An expanded decision-making framework designed to evaluate “judgment” in adults and adolescents can better test the empirical basis of paternalistic legal policies. The theoretical and empirical literature on the informed consent framework is critiqued and an alternative framework incorporating judgment factors is proposed. Three judgment factors—temporal perspective, attitude toward risk, and peer and parental influence—and their effects on decision making are explored. Finally, implications for future research are analyzed in several decision-making contexts. Read the full article.

POST-ADOLESCENT BRAIN MATURATION

It has been a long-held belief that the human brain stopped developing in adolescence. However, in 2011 two researchers from the Faculty of Medicine & Dentistry at the University of Alberta demonstrated that the human brain does not stop developing at adolescence, but instead continues well into the 20s. The study revealed that parts of the brain continue to develop post-adolescence within individual subjects.

Research shows that young adult brains are continuing to develop wiring to the frontal lobe; tracts responsible for complex cognitive tasks such as inhibition, high-level functioning, and attention. This may be due to a plethora of life experiences in young adulthood, such as pursing post-secondary education, starting a career, independence, and developing new social and family relationships. Unfortunately, because the research in this area of development is relatively new, the number of studies is limited.

Abstract: Maturation of the striatum has been posited to play a primary role in observed increases in adolescent sensation-seeking. However, evidence of neurophysiological maturation in the human adolescent striatum is limited. We applied T2*-weighted imaging, reflecting indices of tissue—iron concentration,to provide direct in vivo evidence of neurophysiological development of the human adolescent striatum. Multivariate pattern analysis (MVPA) of striatal T2*-weighted signal generated age predictions that accounted for over 60% of the sample variance in 10–25 year olds, using both task-related and resting state fMRI. Dorsal and ventral striatum showed age related increases and decreases respectively of striatal neurophysiology suggesting qualitative differences in the maturation of limbic and executive striatal systems. In particular, the ventral striatum was found to show the greatest developmental differences and contribute most heavily to the multivariate age predictor. The relationship of the T2*-weighted signal to the striatal dopamine system is discussed. Together, results provide evidence for protracted maturation of the striatum through adolescence. Read the full article.

“Longitudinal Development of Human Brain Wiring Continues from Childhood into Adulthood” by Catherine Lebel and Christian Beaulieu, The Journal of Neuroscience (2011)

Abstract: Healthy human brain development is a complex process that continues during childhood and adolescence, as demonstrated by many cross-sectional and several longitudinal studies. However, whether these changes end in adolescence is not clear. We examined longitudinal white matter maturation using diffusion tensor tractography in 103 healthy subjects aged 5–32 years; each volunteer was scanned at least twice, with 221 total scans. Fractional anisotropy (FA) and mean diffusivity (MD), parameters indicative of factors including myelination and axon density, were assessed in 10 major white matter tracts. All tracts showed significant nonlinear development trajectories for FA and MD. Significant within-subject changes occurred in the vast majority of children and early adolescents, and these changes were mostly complete by late adolescence for projection and commissural tracts. However, association tracts demonstrated postadolescent within-subject maturation of both FA and MD. Diffusion parameter changes were due primarily to decreasing perpendicular diffusivity, although increasing parallel diffusivity contributed to the prolonged increases of FA in association tracts. Volume increased significantly with age for most tracts, and longitudinal measures also demonstrated postadolescent volume increases in several association tracts. As volume increases were not directly associated with either elevated FA or reduced MD between scans, the observed diffusion parameter changes likely reflect microstructural maturation of brain white matter tracts rather than just gross anatomy. Read the full article.

MENTAL HEALTH

Mental disorders are diagnosable conditions characterized by changes in thinking, mood, or behavior (or some combination of these) that can cause a person to feel stressed out and impair his or her ability to function. As with symptoms of physical illness, symptoms of mental disorders occur on a spectrum from mild to severe. Adolescents with mental disorders, however, often have to bear the special burden of the societal stigma associated with their condition. This burden sometimes prevents adolescents and their families from acknowledging illness and from seeking support and effective treatment for it.

Adolescents are biologically prone to have mood swings because the hormonal changes associated with the ongoing development of their brains. Nonetheless, it is still important to recognize when behaviors seem out of the ordinary. When psychological symptoms cause major emotional distress or interfere substantially with daily life and social interactions over a period of time, professional evaluation is warranted, just as it is with any serious illness. It is vital to look for signs such as persistent irritability, anger, or social withdrawal, as well as major changes in appetite or sleep.

Adolescence is a time when many mental disorders first arise; in fact, more than half of all mental disorders and problems with substance abuse begin by age 14, and three—quarters of these difficulties begin by age 24. An estimated one in five adolescents will have a diagnosable disorder. Among the more common anxiety disorders are depression, obsessive-compulsive disorder (OCD), social anxiety disorder, post-traumatic stress disorder (PTSD), and phobias. Adolescents can also develop attention-deficit/hyperactivity disorder (ADHD) causing them to have difficulty paying attention, controlling impulses, and staying organized.

Mental disorders take a toll on adolescents, their parents, and friends, and contribute significantly to health care costs. The consequences can be short or long-term. Indeed, most mental disorders diagnosed among adults began during adolescence, although other mental disorders experienced by adolescents may diminish by early adulthood if they are treated. Adolescents with mental disorders are at increased risk of getting caught up in harmful behaviors, such as substance abuse, violence, and unprotected sexual activity. This is why getting treatment, as early as possible, is so important.

Abstract:
Importance: Major depressive disorder (MDD) frequently emerges during adolescence and can lead to persistent illness, disability, and suicide. The maturational changes that take place in the brain during adolescence underscore the importance of examining neurobiological mechanisms during this time of early illness. However, neural mechanisms of depression in adolescents have been understudied. Research has implicated the amygdala in emotion processing in mood disorders, and adult depression studies have suggested amygdala-frontal connectivity deficits. Resting-state functional magnetic resonance imaging is an advanced tool that can be used to probe neural networks and identify brain-behavior relationships.

Objective: To examine amygdala resting-state functional connectivity (RSFC) in adolescents with and without MDD using resting-state functional magnetic resonance imaging as well as how amygdala RSFC relates to a broad range of symptom dimensions.

Design, Setting, and Participants: A cross-sectional resting-state functional magnetic resonance imaging study was conducted within a depression research program at an academic medical center. Participants included 41 adolescents and young adults aged 12 to 19 years with MDD and 29 healthy adolescents (frequency matched on age and sex) with no psychiatric diagnoses.

Main Outcomes and Measures: Using a whole-brain functional connectivity approach, we examined the correlation of spontaneous fluctuation of the blood oxygen level–dependent signal of each voxel in the whole brain with that of the amygdala.

Results: Adolescents with MDD showed lower positive RSFC between the amygdala and hippocampus, parahippocampus, and brainstem (z >2.3, corrected P < .05); this connectivity was inversely correlated with general depression (R = −.523, P = .01), dysphoria (R = −.455, P = .05), and lassitude (R = −.449, P = .05) and was positively correlated with well-being (R = .470, P = .03). Patients also demonstrated greater (positive) amygdala-precuneus RSFC (z >2.3, corrected P < .05) in contrast to negative amygdala-precuneus RSFC in the adolescents serving as controls.
Conclusions and Relevance: Impaired amygdala-hippocampal/brainstem and amygdala-precuneus RSFC have not previously been highlighted in depression and may be unique to adolescent MDD. These circuits are important for different aspects of memory and self-processing and for modulation of physiologic responses to emotion. The findings suggest potential mechanisms underlying both mood and vegetative symptoms, potentially via impaired processing of memories and visceral signals that spontaneously arise during rest, contributing to the persistent symptoms experienced by adolescents with depression. Read the full article.

Abstract:
Importance: Posttraumatic stress disorder (PTSD), while highly prevalent (7.6% over a lifetime), develops only in a subset of trauma-exposed individuals. Genetic risk factors in interaction with trauma exposure have been implicated in PTSD vulnerability.

Objective: To examine the association of 3755 candidate gene single-nucleotide polymorphisms with PTSD development in interaction with a history of childhood trauma.

Main Outcomes and Measures: Continuous measures of PTSD severity, with a modified (interview) PTSD checklist in the discovery cohort and the PTSD Symptom Scale in the replication cohort.

Results: Controlling for the level of lifetime adult trauma exposure, we identified the novel association of a single-nucleotide polymorphism within the promoter region of the ADRB2 (Online Mendelian Inheritance in Man 109690) gene with PTSD symptoms in interaction with childhood trauma (rs2400707, P = 1.02 × 10−5, significant after correction for multiple comparisons). The rs2400707 A allele was associated with relative resilience to childhood adversity. An rs2400707 × childhood trauma interaction predicting adult PTSD symptoms was replicated in the independent predominantly female African American cohort.

Conclusions and Relevance: Altered adrenergic and noradrenergic function has been long believed to have a key etiologic role in PTSD development; however, direct evidence of this link has been missing. The rs2400707 polymorphism has been linked to function of the adrenergic system, but, to our knowledge, this is the first study to date linking the ADRB2 gene to PTSD or any psychiatric disorders. These findings have important implications for PTSD etiology, chronic pain, and stress-related comorbidity, as well as for both primary prevention and treatment strategies. Read the full article.

Abstract:
Importance: Attention-deficit/hyperactivity disorder (ADHD) has been associated with deficient decision making and learning. Models of ADHD have suggested that these deficits could be caused by impaired reward prediction errors (RPEs). Reward prediction errors are signals that indicate violations of expectations and are known to be encoded by the dopaminergic system. However, the precise learning and decision-making deficits and their neurobiological correlates in ADHD are not well known.

Objective: To determine the impaired decision-making and learning mechanisms in juvenile ADHD using advanced computational models, as well as the related neural RPE processes using multimodal neuroimaging.

Main Outcomes and Measures: Learning and decision making were investigated by contrasting a hierarchical Bayesian model with an advanced reinforcement learning model and by comparing the model parameters. The neural correlates of RPEs were studied in functional magnetic resonance imaging and electroencephalogram.

NEWS ARTICLES

The most significant obstacle to effective treatment of autism is late detection. Early diagnosis is the key to success in helping a child with autism, but it is likely to be delayed by as much as two years in children from disadvantaged or minority families. However, universal autism screening at 18 and 24 months can significantly close this gap in access. Read the full article.

“Autism is Detectable in Brain Scans Long Before Symptoms Appear, New Study Says” by Josh Hafner, USA TODAY (2017)

New research suggests that autism may be detectable within a child’s first year of life. Researchers at the University of North Carolina used brain scans to predict with 80 percent accuracy whether certain children would develop autism. This research could lead to earlier and better interventions for children. Read the full article.

SUBSTANCE ABUSE

When adolescents engage in alcohol and other drug use, they, their families, and their communities usually suffer. In some cases, because of the strong association between substance abuse and delinquency, an increased burden is also placed on the juvenile justice system. However, the worst problem with substance abuse is the personal harm caused to the abuser by the abuser.

Adolescents who suffer from substance abuse are more likely to have declining grades, absenteeism from school and other activities, and increased potential for dropping out of school. Cognitive and behavioral problems experienced by alcohol- and drug-using adolescents may also interfere with their academic performance and also present obstacles to learning for their classmates.

An adolescent’s physical health is also greatly at risk from substance abuse because of injuries due to accidents, physical disabilities and diseases, and the potential and effects of possible overdoses. Disproportionate numbers of adolescents involved with alcohol and other drugs face an increased risk of death through suicide, homicide, accident, and illness.

Substance-abusing adolescents often are alienated from and stigmatized by their peers. The abuse of alcohol and other drugs by adolescents can also result in family crises and jeopardize many aspects of family life, sometimes resulting in family dysfunction. This causes increased burdens on families, friends, and the community in the support of adolescents who are not able to become self-supporting because of their addiction.

Juvenile delinquency is undeniably linked to substance abuse. Arrest, adjudication, and intervention by the juvenile justice system are eventual consequences for many adolescents engaged in alcohol and other drug use. Substance abusers are most commonly associated with violent or income-generating crimes. Gangs, drug trafficking, prostitution, and growing numbers of youth homicides are among the social and criminal justice problems often linked to adolescent substance abuse.

FURTHER READING

Drug Guide for Parents: Learn the Facts to Keep Your Teen Safe

This guide serves to help parents identify drugs that their children may be abusing. The chart lists the most common substances by their street and commercial names, appearance, how it’s consumed, why the drug is dangerous, signs of abuse, etc. Download the guide.

SCIENTIFIC ARTICLES

“Incidence of Drug Problems in Young Adults Exposed to Trauma and Posttraumatic Stress Disorder” by Philip L. Reed, James C. Anthony, and Naomi Breslau, Archives of General Psychiatry (2007)

Abstract:
CONTEXT: Most estimated associations of posttraumatic stress disorder (PTSD) with DSM-IV drug dependence and abuse are from cross-sectional studies or from prospective studies of adults that generally do not take into account suspected causal determinants measured in early childhood.
OBJECTIVE: To estimate risk for incident drug disorders associated with prior DSM-IV PTSD.
DESIGN: Multiwave longitudinal study of an epidemiologic sample of young adults first assessed at entry to first grade of primary school in the fall semesters of 1985 and 1986, with 2 young adult follow-up assessments.
SETTING: Mid-Atlantic US urban community.
PARTICIPANTS: Young adults (n = 988; aged 19-24 years) free of clinical features of DSM-IV drug use disorders at the first young adult assessment and therefore at risk for newly incident drug use disorders during the 1-year follow-up period.
MAIN OUTCOME MEASURES: During the 12-month interval between the 2 young adult follow-up assessments, newly incident (1) DSM-IV drug abuse or dependence; (2) DSM-IV drug abuse; (3) DSM-IV drug dependence; and (4) emerging dependence problems (1 or 2 newly incident clinical features of DSM-IV drug dependence), among subjects with no prior clinical features of drug use disorders.
RESULTS: Prior PTSD (but not trauma only) was associated with excess risk for drug abuse or dependence (adjusted relative risk, 4.9; 95% confidence interval, 1.6-15.2) and emerging dependence problems (adjusted relative risk, 4.9; 95% confidence interval, 1.2-20.1) compared with the no-trauma group controlling for childhood factors. Subjects with PTSD also had a greater adjusted relative risk for drug abuse or dependence compared with subjects exposed to trauma only (adjusted relative risk, 2.0; 95% confidence interval, 1.1-3.8) controlling for childhood factors.
CONCLUSIONS: Association of PTSD with subsequent incident drug use disorders remained substantial after statistical adjustment for early life experiences and predispositions reported in previous studies as carrying elevated risk for both disorders. Posttraumatic stress disorder might be a causal determinant of drug use disorders, possibly representing complications such as attempts to self-medicate troubling trauma-associated memories, nightmares, or painful hyperarousal symptoms. Read the full article.

PREVENTION AND INTERVENTION

Juvenile delinquency is characterized by antisocial behavior that is beyond parental control and subject to legal action. If a child is exhibiting these behaviors or early signs of these behaviors, that does not mean that the child will ever commit a crime, although the likelihood of doing so may increase. How do you change a child that seems to be going down the wrong path? Ultimately, parents may have the most control over the behaviors of their children. When families simply find time to be together, it can increase the possibility for positive outcomes and delinquency prevention. A survey from Columbia University showed that children from families who had dinner together five to seven times per week were significantly less likely to experiment with legal or illegal substances.

Additionally, teenagers whose parents are not actively involved or interested in their lives are more likely to become bullies, which may ultimately lead to involvement in gangs or violent behavior. By simply taking an active interest in their children’s lives, parents are in an incredibly powerful position to help stave off juvenile delinquency. However, parents cannot solve this problem on their own, and many do not even realize how important their role is in preventing delinquent behavior.

If children do not have a strong family unit to support them, such as children in foster care, placement, or temporary housing, then they need to look to building up protective factors that may reduce the likelihood of delinquency. Protective factors are traits or experiences that help counteract risk factors. Communities and schools can help accomplish this by fostering the positive in children.

Children are generally resilient and able to manage stress and function well—even when faced with adversity and trauma. By emotionally supporting children, minimizing their stressors, and building relationships with them—a parent or caregiver can change a child’s entire life for the better.

FURTHER READING

SCIENTIFIC ARTICLES

“Empirically Based Strategies for Preventing Juvenile Delinquency” by Dustin A. Pardini, Child and Adolescent Psychiatric Clinics of North America (2016)

Abstract: Juvenile crime is a serious public health problem that results in significant emotional and financial costs for victims and society. Using etiologic models as a guide, multiple interventions have been developed to target risk factors thought to perpetuate the emergence and persistence of delinquent behavior. Evidence suggests that the most effective interventions tend to have well-defined treatment protocols, focus on therapeutic approaches as opposed to external control techniques, and use multimodal cognitive-behavioral treatment strategies. Moving forward, there is a need to develop effective policies and procedures that promote the widespread adoption of evidence-based delinquency prevention practices across multiple settings. Purchase access to the full article.

Abstract: Existing reviews of the impact of restorative justice programs on juvenile recidivism have reached mixed conclusions. The present meta-analysis identified relevant studies through a systematic search of 20 databases over a 25-year period as well as the ancestry method. Application of inclusion criteria resulted in a set of 21 studies contributing 21 independent effect sizes. Programs were found to be overall effective at reducing recidivism, with a pooled odds ratio of 1.28. Subgroup analyses indicate strong evidence that study and treatment characteristics play a role in evaluation results, such as strength of research design and racial/ethnic mix of program participants. Overall quality of the literature is relatively weak, with the large majority of studies derived from non-peer-reviewed sources and a lack of detail presented on treatment characteristics. Limitations with respect to exclusion criteria, sample sizes, and between-study heterogeneity are discussed. Read the full article.

“Juvenile Pre-Arrest Diversion in Florida” by Florida TaxWatch (2016)

This briefing discuses the expansion of juvenile pre-arrest diversion programs (JPADs) in Florida. According to this source, such programs have resulted in reduced recidivism during both adolescence and adulthood and increased cost efficiency and return on investment. Florida, however, has also faced a number of issues in application, resulting in a juvenile justice system where “the level of punishment is a better reflection of Florida’s geography than the severity of the crime committed.” Read the full briefing.

Abstract: Participation in sports activities is very popular among adolescents, and is frequently encouraged among youth. Many psychosocial health benefits in youth are attributed to sports participation, but to what extent this positive influence holds for juvenile delinquency is still not clear on both the theoretical and empirical level. There is much controversy on whether sports participation should be perceived as a protective or a risk factor for the development of juvenile delinquency. A multilevel meta-analysis of 51 published and unpublished studies, with 48 independent samples containing 431 effect sizes and N = 132,366 adolescents, was conducted to examine the relationship between sports participation and juvenile delinquency and possible moderating factors of this association. The results showed that there is no overall significant association between sports participation and juvenile delinquency, indicating that adolescent athletes are neither more nor less delinquent than non-athletes. Some study, sample and sports characteristics significantly moderated the relationship between sports participation and juvenile delinquency. However, this moderating influence was modest. Implications for theory and practice concerning the use of sports to prevent juvenile delinquency are discussed. Read the full article.

“The Prevention of Detention” by David A. Brent, and Rolf Loeber, The American Journal of Psychiatry (2015)

This article discusses how intervention can be used to prevent detention in later life. In particular, the authors focus on the Fast Track prevention program, which has the goal of attenuating the “trajectory of disruptive behavior and associated sequlae” in youths. Read the full article.

“Delinquent Behavior, the Transition to Adulthood, and the Likelihood of Military Enlistment” by Jay Teachman and Lucky Tedrow, Social Science Research (2014)

Abstract: Using data taken from the 1997 National Longitudinal Survey of Youth we examine the relationship between delinquency and enlistment in the military. We argue that delinquent behavior is positively related to enlistment because military service is an attractive alternative for delinquents to mark their transition to adulthood and their desistance from delinquent behavior. We also argue, however, that this relationship is not linear, with higher levels of delinquent behavior actually acting to reduce the likelihood of enlistment. We further suggest that the relationship between delinquency and enlistment is similar for men and women. We test and find support for our hypotheses using data taken from the 1997 National Longitudinal Survey of Youth. Read the full article.

“How to Turn Around Troubled Teens” by Hal Arkowitz and Scott O. Lillenfeld, Scientific American (2014)

This article discusses a number of ineffective get-tough treatments for delinquent juveniles, including boot camp, Scared Straight programs, and juvenile transfer laws. Read the full article.

Abstract: Pre- and postcharge diversion programs have been used as a formal intervention strategy for youth offenders since the 1970s. This meta-analysis was conducted to shed some light on whether diversion reduces recidivism at a greater rate than traditional justice system processing and to explore aspects of diversion programs associated with greater reductions in recidivism. Forty-five diversion evaluation studies reporting on 73 programs were included in the meta-analysis. The results indicated that diversion is more effective in reducing recidivism than conventional judicial interventions. Moderator analysis revealed that both study- and program-level variables influenced program effectiveness. Of particular note was the relationship between program-level variables (e.g., referral level) and the risk level targeted by programs (e.g., low or medium/high). Further research is required implementing strong research designs and exploring the role of risk level on youth diversion effectiveness. Read the full article.

“What Doesn’t Work in Preventing and Reducing Juvenile Delinquency” by James C. Howell, Preventing and Reducing Juvenile Delinquency: A Comprehensive Framework (2003)

Abstract: Thanks to the voluminous increase in the number of program evaluations in the past couple of decades, evidence is accumulating that some prevention and intervention strategies and programs simply do not work with juvenile offenders. I address many of the strategies and programs that do not work in the first two main sections of this chapter, and then discuss the evidence to date on many others for which the research findings are unclear, contradictory, or nonexistent. I discuss two particular ineffective strategies in some detail in later chapters: In Chapter 8, I address the failed policy of transferring juveniles to the criminal justice system, and in Chapter 11, I review some of the ineffective “collaboration” strategies that have been used in some jurisdictions for dealing with juvenile delinquency. Read the full chapter.

“Scared Straight and Other Juvenile Awareness Programs for Preventing Juvenile Delinquency: A Systematic Review of the Randomized Experimental Evidence” by Anthony Petrosino, Carolyn Turner-Petrosino, and John Buehler, The Annals of the American Academy of Political and Social Science (2003)

Abstract: Scared Straight and other programs involve organized visits to prison facilities by juvenile delinquents or at-risk kids to deter them from delinquency. Despite several research studies and reviews questioning their effectiveness, they remain in use and have now been tried in at least six nations. The authors report here on the results of a systematic review of randomized experimental tests of this program. Studies that tested any program involving the organized visits of delinquents or at-risk children to penal institutions were included. Each study had to have a no-treatment control condition with at least one outcome measure of “postvisit” criminal behavior. Using extensive search methods, the authors located nine randomized trials meeting eligibility criteria. After describing the studies and appraising their methodological quality, the authors present the narrative findings from each evaluation. A meta-analysis of prevalence rates indicates that the intervention on average is more harmful to juveniles than doing nothing. The authors conclude that governments should institute rigorous programs of research to ensure that well-intentioned treatments do not cause harm to the citizens they pledge to protect. Read the full article.

REPORTS

Beyond Bars: Keeping Young People Safe at Home and Out of Youth Prisons by the National Collaboration for Youth (2016)

Abstract: Beyond Bars advocates for communities and systems to close youth prisons by developing a vast array of services and supports that can hold youth accountable in the community while also meeting their needs and building on strengths. It offers a blueprint for systems and communities to establish guiding principles, core services and an organizing tool to shift from a facility-based juvenile justice system to a community-based youth justice system. Some of guiding principles include focusing on need and not slots; building on restoring a sense of relatedness by building on strengths, competency and autonomy; asset mapping communities that are often characterized only by their deficits, and; implementing culturally competent programs. While every community is different, the report also focuses on core services that should comprise the bedrock of any continuum of care, along with key strategies to create a robust array of community support and services for young people in need. Read the report.

THE EFFECTS OF INCARCERATION

The United States imprisons more youths at a higher rate than any other nation. Incarceration can affect teens in many ways. Adolescents who are incarcerated are much less likely to return to school upon release. Of those who do receive an education while incarcerated and return to school after release, on average 16 percent drop out within five months. The combination of incarceration and lack of schooling also has a negative effect on an adolescent’s work potential. This causes long-term problems, such as homelessness, drug and alcohol abuse, and recidivism. In fact, recidivism rates are extremely high among adolescents that are incarcerated compared to adolescents who entered diversionary programs.

This report discusses the results of a nationwide survey of the laws and policies governing the use of solitary confinement in juvenile justice facilities. The report details how each state imposes solitary confinement, for what purposes, for what length of time, with which conditions, and whether there are due-process protections in place. Read the full report.

Abstract: Despite its devastating psychological, physical, and developmental effects on juveniles, solitary confinement is used in juvenile correctional facilities across the United States. This Comment posits that such treatment violates the Eighth Amendment’s Cruel and Unusual Punishment Clause, the United Nations’ Convention on the Rights of the Child, and the Convention Against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment. It likewise argues that that President Obama’s recent Executive Order banning juvenile solitary confinement is simply not a powerful enough remedy and discusses why it must be paired with Congressional legislation or Supreme Court jurisprudence if it is to have any lasting effect. Read the full article.

Abstract: A growing literature suggests that juvenile arrests perpetuate offending and increase the likelihood of future arrests. The effect on subsequent arrests is generally regarded to be a product of the perpetuation of criminal offending. However, increased rearrest may also reflect differential law enforcement behavior. Using longitudinal data from the Project on Human Development in Chicago Neighborhoods (PHDCN) together with official arrest records, the current study estimates the effects of first arrests on both reoffending and rearrest. Propensity score methods were used to control differences between arrestees and non-arrestees and minimize selection bias. Among 1,249 PHDCN youth, 58 were first arrested during the study period; 43 of these arrestees were successfully matched to 126 control cases who were equivalent on a broad set of individual, family, peer, and neighborhood factors. We find that first arrests increased both the likelihood of subsequent offending and of subsequent arrest, through separate processes. The effects on rearrest are substantially larger and largely independent of the effects on reoffending, suggesting that labels trigger “secondary sanctioning” processes distinct from secondary deviance processes. Attempts to ameliorate deleterious labeling effects should include efforts to dampen their escalating punitive effects on societal responses. Read the full article.

“Alone and Afraid: Children Held in Solitary Confinement and Isolation in Juvenile Detention and Correctional Facilities” by the American Civil Liberties Union (2014)

Abstract: This report by the American Civil Liberties Union examines the negative impact on children held in solitary confinement and isolation while incarcerated in juvenile detention and correctional facilities. Solitary confinement involves the physical and social isolation in a cell for 22 to 24 hours per day and is the most extreme form of isolation. Research has shown that the use of solitary confinement and other forms of isolation in juvenile justice facilities can have serious negative consequences for incarcerated youth. Youth subjected to this treatment can suffer serious psychological, physical, and developmental harm, resulting in persistent mental health problems or even suicide. These problems are often magnified for incarcerated youth with histories of trauma and abuse or for those with disabilities. This report discusses the consequences resulting from the use of solitary confinement and isolation in juvenile detention and correctional facilities, explores why children are subjected to these conditions, and examines how solitary confinement and other isolation practices are currently regulated at the State and Federal levels. The report also provides information on U.S. and human rights laws that offer specific protections for young people involved with the criminal justice system, and suggests steps that should be taken to stop the use of solitary confinement for incarcerated youth. Read the full report.

“Juvenile Arrest and Collateral Educational Damage in the Transition to Adulthood” by David S. Kirk and Robert J. Sampson, American Sociological Association (2013)

Abstract: Official sanctioning of students by the criminal justice system is a long-hypothesized source of educational disadvantage, but its explanatory status remains unresolved. Few studies of the educational consequences of a criminal record account for alternative explanations such as low self-control, lack of parental supervision, deviant peers, and neighborhood disadvantage. Moreover, virtually no research on the effect of a criminal record has examined the ‘‘black box’’ of mediating mechanisms or the consequence of arrest for postsecondary educational attainment. Analyzing longitudinal data with multiple and independent assessments of theoretically relevant domains, the authors estimate the direct effect of arrest on later high school dropout and college enrollment for adolescents with otherwise equivalent neighborhood, school, family, peer, and individual characteristics as well as similar frequency of criminal offending. The authors present evidence that arrest has a substantively large and robust impact on dropping out of high school among Chicago public school students. They also find a significant gap in four-year college enrollment between arrested and otherwise similar youth without a criminal record. The authors also assess intervening mechanisms hypothesized to explain the process by which arrest disrupts the schooling process and, in turn, produces collateral educational damage. The results imply that institutional responses and disruptions in students’ educational trajectories, rather than social-psychological factors, are responsible for the arrest–education link. Read the full article.

“Growing Up Locked Down: Youth in Solitary Confinement in Jails and Prisons Across the United States” by Human Rights Watch and the American Civil Liberties Union (2012)

Abstract: Every day in jails and prisons across the United States, large numbers of young people under age 18 are held in solitary confinement. They spend 22 or more hours each day physically and socially isolated in a small cell, often for weeks or even months on end. Adolescents in solitary confinement are routinely denied access to needed treatment, services, and programming. The practice is serious and widespread.

The solitary confinement of adults can cause severe pain and suffering and can violate international human rights and US constitutional law. But the potential damage to young people, who do not have the maturity of an adult and are at a particularly vulnerable stage of life, is much greater. Yet, solitary confinement of young people is not necessary; there are alternative ways to address the problems that officials cite as justifications for using solitary confinement.

Human Rights Watch and the American Civil Liberties Union call on US federal and state governments to prohibit the solitary confinement of young people under age 18; prohibit the housing of adolescents with adults or in adult jails and prisons; strictly limit and regulate all forms of segregation and isolation; and monitor and report on the segregation and isolation of young people, whenever they are deprived of their liberty. Read the full report.

Copyright 2017, Public Defender, Ninth Judicial Circuit. The material found on this web site is for informational purposes only. It should not be considered to be legal advice and is not guaranteed to be complete or up to date. Use of this web site is not intended to create, nor constitute, an attorney-client relationship. Readers should not rely upon or act upon this information without seeking professional counsel.